Dental Blue

Effective January 1, 2016, Blue Cross Blue Shield of Massachusetts (Dental Blue) will become the Dental Plan administrator. With Blue Cross Blue Shield of Massachusetts administering both the Medical Plan and the Dental Plan, our members will enjoy several advantages. Overall plan costs will be lower, you will have access to an integrated approach to medical and dental care, and we are able to provide better dental coverage.

The Dental Blue Network

Dental Blue offers a broad network of providers. You probably will not need to change dentists; in fact, 81% of dentists our members currently use participate in the Dental Blue network. Currently, 85% of dentists our members use participate in the Delta Dental network. And, you will have easy access to in-network dentists, with 92% of you living within eight miles of at least two Dental Blue network dentists. You can see if your current dentist is in the Dental Blue network by visitingwww.bluecrossma.com/wps/portal/members/using-my-plan/doctors-hospitals/findadoctor.

• If your current dentist is a member of the Dental Blue network, no action is required. You’ll receive a new dental ID card in December. When you go to the dentist starting January 1, 2016, show your new dental ID card.

• If your current dentist is not part of the Dental Blue network, consider changing to an in-network dentist. Or, call Dental Blue at 1-800-882-1178 so they can contact your dentist and try to add him or her to the network.

Improved Benefits

Expanded coverage and enhanced benefits will help you meet more of your dental care needs.

Beginning January 1, 2016:

• Preventive and diagnostic care is covered at 100%, regardless of whether you receive care from an in-network or out-of-network dentist.

• Two fluoride treatments per year are covered, regardless of age.

• All synthetic (white) fillings are covered for all teeth at 80%.

• Crowns, inlays, and onlays are covered at 80%.

• Orthodontia is covered regardless of age, with a new lifetime maximum of $2,500 per person for non-medically necessary orthodontia.

• Nitrous oxide (laughing gas) is covered as part of the Plan’s general anesthesia benefit.

If you receive care from an out-of-network dentist who charges more than the Dental Blue usual and customary charge, you will need to pay any amount the dentist

charges that exceeds Dental Blue’s allowance. For example, if the usual and customary charge is $100 for a cleaning and your out-of-network dentist charges $120,